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Preclinical Performance Evaluation of a Robotic Endoscope for Non-Contact Laser Surgery.

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Title: Preclinical Performance Evaluation of a Robotic Endoscope for Non-Contact Laser Surgery.
Authors: Kundrat, D.1,2 (AUTHOR) dennis.kundrat@imes.uni-hannover.de, Graesslin, R.3,4 (AUTHOR), Schoob, A.1 (AUTHOR), Friedrich, D. T.5 (AUTHOR), Scheithauer, M. O.3,4 (AUTHOR), Hoffmann, T. K.3,4 (AUTHOR), Ortmaier, T.1 (AUTHOR), Kahrs, L. A.1,6 (AUTHOR), Schuler, P. J.3,4 (AUTHOR)
Source: Annals of Biomedical Engineering. 2021, Vol. 49 Issue 2, p585-600. 16p.
Subjects: Laser surgery, Standard deviations, Larynx, Robotics, Laser ablation, Surgical robots, Stereo vision (Computer science)
Abstract: Despite great efforts, transoral robotic laser surgery has not been established clinically. Patient benefits are yet to be proven to accept shortcomings of robotic systems. In particular, laryngeal reachability and transition from microscope to accurate endoscopic laser ablation have not been achieved. We have addressed those challenges with a highly integrated robotic endoscope for non-contact endolaryngeal laser surgery. The current performance status has been assessed in multi-level user studies. In addition, the system was deployed to an ex vivo porcine larynx. The robotic design comprises an extensible continuum manipulator with multifunctional tip. The latter features laser optics, stereo vision, and illumination. Vision-based performance assessment is derived from depth estimation and scene tracking. Novices and experts (n = 20) conducted teleoperated delineation tasks to mimic laser ablation of delicate anatomy. Delineation with motion-compensated and raw endoscopic visualisation was carried out on planar and non-planar nominal patterns. Root mean square tracing errors of less than 0.75 mm were feasible with task completion times below 45 s. Relevant anatomy in the porcine larynx was exposed successfully. Accuracy and usability of the integrated platform bear potential for dexterous laser manipulation in clinical settings. Cadaver and in vivo animal studies may translate ex vivo findings. [ABSTRACT FROM AUTHOR]
Copyright of Annals of Biomedical Engineering is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Preclinical Performance Evaluation of a Robotic Endoscope for Non-Contact Laser Surgery.
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  Data: <searchLink fieldCode="JN" term="%22Annals+of+Biomedical+Engineering%22">Annals of Biomedical Engineering</searchLink>. 2021, Vol. 49 Issue 2, p585-600. 16p.
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  Data: <searchLink fieldCode="DE" term="%22Laser+surgery%22">Laser surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Standard+deviations%22">Standard deviations</searchLink><br /><searchLink fieldCode="DE" term="%22Larynx%22">Larynx</searchLink><br /><searchLink fieldCode="DE" term="%22Robotics%22">Robotics</searchLink><br /><searchLink fieldCode="DE" term="%22Laser+ablation%22">Laser ablation</searchLink><br /><searchLink fieldCode="DE" term="%22Surgical+robots%22">Surgical robots</searchLink><br /><searchLink fieldCode="DE" term="%22Stereo+vision+%28Computer+science%29%22">Stereo vision (Computer science)</searchLink>
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  Data: Despite great efforts, transoral robotic laser surgery has not been established clinically. Patient benefits are yet to be proven to accept shortcomings of robotic systems. In particular, laryngeal reachability and transition from microscope to accurate endoscopic laser ablation have not been achieved. We have addressed those challenges with a highly integrated robotic endoscope for non-contact endolaryngeal laser surgery. The current performance status has been assessed in multi-level user studies. In addition, the system was deployed to an ex vivo porcine larynx. The robotic design comprises an extensible continuum manipulator with multifunctional tip. The latter features laser optics, stereo vision, and illumination. Vision-based performance assessment is derived from depth estimation and scene tracking. Novices and experts (n = 20) conducted teleoperated delineation tasks to mimic laser ablation of delicate anatomy. Delineation with motion-compensated and raw endoscopic visualisation was carried out on planar and non-planar nominal patterns. Root mean square tracing errors of less than 0.75 mm were feasible with task completion times below 45 s. Relevant anatomy in the porcine larynx was exposed successfully. Accuracy and usability of the integrated platform bear potential for dexterous laser manipulation in clinical settings. Cadaver and in vivo animal studies may translate ex vivo findings. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Annals of Biomedical Engineering is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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